Provider Demographics
NPI:1093285231
Name:BEC ENTERPRISES LLC
Entity Type:Organization
Organization Name:BEC ENTERPRISES LLC
Other - Org Name:BLUE EARTH TAXI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICK
Authorized Official - Middle Name:W
Authorized Official - Last Name:WININGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:507-779-9400
Mailing Address - Street 1:360 PIERCE AVE STE 106
Mailing Address - Street 2:
Mailing Address - City:NORTH MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56003-2208
Mailing Address - Country:US
Mailing Address - Phone:507-388-2227
Mailing Address - Fax:
Practice Address - Street 1:320 S MINNESOTA AVE
Practice Address - Street 2:
Practice Address - City:SAINT PETER
Practice Address - State:MN
Practice Address - Zip Code:56082-2524
Practice Address - Country:US
Practice Address - Phone:507-388-2227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BEC ENTERPRISES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-30
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNB872083647817Medicaid